[娱乐性药物使用后的急性心血管疾病]
Femke M J Gresnigt1,2, Eric J F Franssen3, Dylan de Lange4
1OLVG, Amsterdam. Afd. Spoedeisende Hulp.
Nederlands tijdschrift voor geneeskunde
|November 19, 2025
概括
娱乐性药物使用,特别是兴奋剂和大麻,与严重的心脏问题有关. 医疗保健提供者应该始终询问心血管疾病患者的药物使用情况,以指导治疗.
科学领域:
- 心脏病学 心脏病学
- 毒理学 毒理学 毒理学
- 公共卫生 公共卫生
背景情况:
- 娱乐性吸毒很普遍,影响了荷兰4.7%的人.
- 兴奋剂和大麻使用与严重的心血管并发症有关,包括心律不整和急性冠状动脉综合征.
- 自我报告的药物使用的可靠性往往很低,需要有针对性的调查.
研究的目的:
- 突出娱乐性药物使用与心血管事件之间的关联.
- 告知临床医生关于娱乐性药物使用在患有心血管疾病的患者中的诊断和管理影响.
- 审查当前的治疗策略和风险分层工具.
主要方法:
- 关于娱乐性药物使用和心血管并发症的文献综述.
- 讨论诊断工具,如胸痛患者的HEART分数.
- 对药物诱导心血管事件的治疗方式的分析.
主要成果:
- 娱乐性药物使用是心血管紧急情况的一个重要因素,从心到心脏突然死亡.
- 心脏分数适用于没有修改的胸痛患者的风险分层.
- 对所有患者来说,可能不需要长期观察期.
- 具体的治疗包括镇静剂,抗高血压药,冠状动脉血管学和抗失常药.
结论:
- 临床医生必须询问心血管症状患者的娱乐性药物使用情况,因为它会影响管理.
- 对于报告为娱乐性物质使用的患者来说,药物咨询是必不可少的.
- 考虑使用特定的抗节律药物,如labetalol,carvedilol,利多卡因和二碳酸治疗心律不整;β阻塞剂在心力衰竭中可能有益,减少排气分数.
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